STROKE CASE STUDIESPrepared by Arlyn M. Valencia, M.D.

60 year-old right handed WM with h/o HTN (hypertension), recent MI (myocardial infarction)who had sudden-onset Broca’s aphasia (mute), right central facial paralysis, right pronator drift

Left Middle Cerebral ArteryBranch Infarct (Stroke)(Note: Not the entire territory of MCAIs involved; the stroke is pie-shaped and involves both gray & white matter)

Probable etiology: with the history of MI, cardioembolic.

More clearly defined infarct, frontal lobe

70 year-old right handed WF, smoker, has h/o HTN, DM (diabetes mellitus), non-compliant with meds.

PE: left carotid bruit; edema on right arm NE: awake, alert, with global aphasia, left

gaze deviation, no response to visual threat presented on right visual field; right hemiparesis (RUE plegic, RLE 3/5 long-tract pattern of weakness), impaired sensation on the right side

70 year-old WM who had new-onset right-sided weakness, leg weaker than arm, abulia (lack of spontaneity)

Left Anterior Cerebral Artery Infarct (ACA)

Left Anterior Cerebral Artery (ACA) Infacrt

69 year-old right-handed BM, brought in by wife who found patient on floor. When asked, patient’s only complaint was headache.

Examination revealed an awake, alert patient with anosognosia; left hemineglect; right gaze preference, inattention to left field; extinction to double simultaneous stimulation (visual and sensory) ; left hemiparesis, arm weaker than leg, left hemisensory deficits

Right Middle Cerebral Artery (MCA) Territory Infarct ) Full MCA Stroke

36 year-old right handed, with h/o previous DVT’s (deep venous thrombosis), lethargic, right gaze deviation, left hemiplegia, hemisensory, later became comatose with decerebrate posturing, anisocoria (right pupil >left)

Right Middle Cerebral Artery Stroke With Edema And Midline Shift

Posterior Cerebral Artery Infarct

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